1979, 10-05 Permit: 79-5379 Furnace, DuctworkPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 4 COPIES
Zi JOB ADDRESS
/4'706,
LOT BLOCK
SUBDIVISION
2 Po
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
4' ADDRESS
i ;Le1I
ER e
ADDRESS
/0,o( �a /6
NTRACTOR��--��
L' �C b i4
DESIGNER
5' ADDRESS
PHONE
ZIP
PHONE
Required Set Backs in Feet
North 'South East 'West
Size of Parcel
Type Const.
Zone Classification
Occupancy Sprinklered
❑Yes ❑No ❑ Req'd.
Valuation Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area Garage Area
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
TYPE A NEW
7. OF
WORK $BLD.
❑ ALT. ���❑yyy AD N. ❑ RPL. ❑ MVE.
❑ PLMB. 7�(I MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Storage
Rancher
Rec. Room
Not Req'd.
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
DESCRIBE WORK
VALUATION
9.
L-Ec— t 12 1 c.... rL) EA‘) el Q C: .: *up- -t-t. c—i-c-L) c) P— k.i
Source
of
Utilities
GAS
ECTRIC
Fe A
WATER SEWER
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or to I law regulating co r truction or the
performance of construction.
DATE ife/� / 7
SIGNATUR
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Health Y
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIKL CONDITIONS:
DATE / —1/ OFFICIAI BSI4CGZ4^I- mow"-'"
APPROVED FOR ISSUANCE
FEES COLLECTED
Cam+
Single $ °
Building
Plumbing
G�
Mech. �'
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $ /
M
i
PERMIT NUMBER
79-5-.379
DATE /d -4'`75?
04* *9,00
*9.00
*9.006
E *0.00
537.82
10 -05 -79
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
111-0 5'- 7 9
55`7,92 *9.00
DATE REMARKS
•
RECORD OF INSPECTIONS
Final Inspection
INSPECTED BY
Jo -C2 -Sa
22581
t
*.G C.0
v.doo"
x
MaGO
art* *600